Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.
Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.
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DOI：
10.1111/jgs.15031
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发表时间：
2017-12
影响因子：
6.3
通讯作者：
McClintock MK
中科院分区：
文献类型：
--
作者：
Pinto JM;Wroblewski KE;Huisingh-Scheetz M;Correia C;Lopez KJ;Chen RC;Kern DW;Schumm PL;Dale W;McClintock MK
老年人的经典感官（视觉，嗅觉，听觉，触觉和味觉）受损可能反映了基本的神经生理老化，并与身体功能不良有关。我们评估了整体感觉障碍（GSI，感觉功能障碍的综合指标）作为身体功能，认知，整体健康和死亡率的预测因子。国家社会生活，健康和老龄化项目（NSHAP），3005个家庭居住的美国老年人的国家概率样本，在基线（2005-2006）和5年随访（2010-2011）进行评估。在基线时，GSI较差的老年人较慢（计时起床和行动时间; OR 1.32，95%CI 1.17-1.50），日常生活活动能力有更多缺陷（≥ 2; OR 1.26，95%CI 1.10-1.46）。5年后，他们仍然较慢（计时步行; OR 1.22，95%CI 1.05-1.42），并且有更多的残疾（≥ 2项日常生活工具活动; OR 1.45，95%CI 1.23-1.70）。他们也不太活跃（通过加速度计进行的日间活动; β=-2.7，95%CI-5.2 to-0.2），认知功能更差（蒙特利尔认知评估; β=-0.64，95%CI-0.84 to-0.44）。最后，他们更可能有更差的整体健康状况（OR = 1.16，95%CI 1.03-1.31），体重减轻（>10%; OR 1.31，95%CI 1.04-1.64），并面临更高的5年死亡率（OR 1.45，95%CI 1.19-1.76）。所有分析均针对基线时的相关混杂因素进行了调整，包括年龄、性别、种族/民族、教育、吸烟、问题饮酒、体重指数、合并症和认知功能。GSI可预测美国老年人5年后的身体功能受损、认知功能障碍、体重显著减轻和死亡率。多感官评估可以识别脆弱的患者，提供早期干预的机会，以减轻不良后果。
Impairment across the classical senses of older adults (vision, smell, hearing, touch, and taste) may reflect fundamental neurophysiological aging and be associated with poor physical function. We evaluated global sensory impairment (GSI, an integrated measure of sensory dysfunction) as a predictor of physical function, cognition, overall health and mortality. The National Social Life, Health, and Aging Project (NSHAP), a national probability sample of 3005 home-dwelling older US adults, assessed at baseline (2005–2006) and 5-year follow-up (2010–2011). Gait Speed, Activity, Disability, Cognition, Overall Health and 5-Year Mortality At baseline, older adults with worse GSI were slower (Timed Up and Go times; OR 1.32, 95%CI 1.17–1.50) and had more deficits in Activities of Daily Living (≥ 2; OR 1.26, 95%CI 1.10–1.46). Five years later, they were still slower (Timed Walk; OR 1.22, 95%CI 1.05–1.42), and had more disabilities (≥ 2 Instrumental Activities of Daily Living; OR 1.45, 95%CI 1.23–1.70). They also were less active (daytime activity by accelerometry; β= −2.7, 95%CI −5.2 to −0.2) and had worse cognitive function (Montreal Cognitive Assessment; β= −0.64, 95%CI −0.84 to −0.44). Finally, they were more likely to have poorer overall health (OR = 1.16, 95%CI 1.03–1.31), lost weight (>10%; OR 1.31, 95%CI 1.04–1.64) and faced higher odds of 5-year mortality (OR 1.45, 95%CI 1.19–1.76). All analyses were adjusted for relevant confounders at baseline, including age, gender, race/ethnicity, education, smoking, problem drinking, body mass index, comorbidities and cognitive function. GSI predicts impaired physical function, cognitive dysfunction, significant weight loss, and mortality 5 years later in older US adults. Multisensory evaluation may identify vulnerable patients, offering the opportunity for early intervention to mitigate adverse outcomes.
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